Just*in Time: July 2016

by Justin B. Terry-Smith

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Dear Justin—

[dropcap]I[/dropcap] hope you get to read this because I’m in desperate need of an answer about HIV prevention.

I actually met you years ago when you were the speaker at Howard University for Black AIDS Awareness. I was a freshman then and I didn’t know a lot about HIV. I think the reason why is because I didn’t know how to accept the fact that I was gay. When I finally acknowledged it, I thought about your presentation at Howard University. It scared me because I didn’t want to be HIV-positive. I had a boyfriend and we had sex only about twenty-five times. He was very abusive verbally at first and that really took a toll on my self-esteem; then he became physically abusive and would throw things at me in the house, punching me, smacking me, etc. I left him and now I have a new boyfriend.

My new boyfriend is amazing, but he is also HIV-positive. He doesn’t want to use condoms but he wants me to go on PrEP; I kinda already know what I want to do but I really wanted to know what you would do in this situation. Do not worry—I’m not basing my decision on what you say, but I am going to take it into consideration.
—A

Photo by Don Harris © Don Harris Photographics, LLC. All rights reserved.
Photo by Don Harris © Don Harris Photographics, LLC. All rights reserved.

[dropcap]I[/dropcap] hope all is well. I, too, have been in an abusive relationship before and I am glad that you made it out of it. As you stated, domestic violence can decrease self-esteem, thus leaving those victims more susceptible to becoming infected with HIV. That is, an individual experiencing violence may not take precautions to protect himself or herself. Sexual health may seem like the least of their worries.

You mentioned precautions in your letter, so it sounds like you are taking more ownership of your sexual health. In that context, let’s talk about PrEP. PrEP is ninety-two to ninety-six-percent effective in preventing HIV transmission. If I were HIV-negative and I had my choice again, at first the decision would be hard for me. I would have to think about the benefits and the limitations. I would probably choose to use PrEP over condoms and I wouldn’t look back. If I were in a relationship at the time I would probably want to have a talk with my boyfriend and our doctor(s) to see what HIV preventative prophylaxis would be beneficial to the both of us.

You have to understand that I am from Generation X. We were the generation that grew up with condoms as the primary way to prevent HIV transmission. It was the preferred way, at least for me. The other way was abstinence and there was no way in hell I was going to do that. No matter what, however, taking control of your sexual health sometimes comes with struggles.

I lost my virginity to a female at thirteen and used a condom; I lost my virginity to a male at seventeen and used a condom as well. I used a condom until the age of nineteen, when I had sex with a guy that excited me enough to stop the precautions.

Then two so-called “friends” informed me that he was HIV-positive. I cried my eyes out for hours; I agonized about going back to base (I was in the United States Air Force) and taking an HIV test. I took one test when I got to base and then one test three months later and I was HIV-negative. Then days later after the three-month test, I found out it was a cruel joke and he wasn’t HIV-positive and my so-called “friends” were just jealous. In a way, they were controlling my sexual health—not me.

The point of my telling you this story is to take control of your own sexual health. Whatever you choose, whether it be condoms or PrEP (or condoms and PrEP), the point is that you are the one taking control. You make the choice of how you want to protect yourself and others around you. Granted, the general message is to use both condoms and PrEP at the same time, but we don’t live in a reality where we can be assured that that practice will catch on. People are going to make their own choices about their own sexual health, as you have here, and as everyone else should feel they have a right to do so.


Justin B. Terry-Smith, MPH, has been fighting the good fight since 1999. He’s garnered recognition and awards for his work, but he’s more concerned about looking for new ways to transform society for the better than resting on his laurels. He started up in gay rights and HIV activism in 2005, published an HIV-themed children’s book, I Have A Secret (Creative House Press) in 2011, and created his own award-winning video blog called, “Justin’s HIV Journal”: justinshivjournal.blogspot.com. Presently, he is working toward his doctorate in public health. Visit his main Web site at www.justinbsmith.com. He welcomes your questions at [email protected].